Three German doctors and a surgery nurse have decided to forego
well deserved vacations beneath tropical palms or in crisp mountain air
to head for Pakistan, where the quarter from Duisburg (located at the
western end of the Ruhr District) hope to help both Afghan refugees and
resident Pakistanis near the refugee camps. The four, including plastic
surgeons Peter Preissler and Juergen Toenissen, anesthesiologist Harald
Hofer, and anesthesiological nurse Dagmar Klode, will travel to
Peshawar, the border city near the Khyber Pass, to operate people with
congenital disfigurements or such resulting from war injuries.

"The gratitude of the people we are able to help is more than
enough reward for all our efforts," says Dr. Preissler. "At
first, they're mostly very sceptical," he says in recalling an
earlier undertaking in Thai clinics and refugee camps along the border
with Cambodia. "At times, too, they're very fearful, but, when
they see themselves in the mirror after the operation, they're
very, very happy." Because of the difficult working conditions in
Pakistan, the medical team is bringing all kinds of equipment along,
"simple devices, including a hand-operated bellows for maintaining
the breathing of anesthesized patients," Dr. Hofer explained.
"We know that we can manage without sophisticated technology,"
Dr. Toenissen added. The latter has previously worked in Third-World
nations and is confident that complications will not crop up. He's
determined to show patients and colleagues back home that effective help
can also be provided by resorting to "basic methods."

The Duisburg team plans to work without pay in Pakistan for several
weeks. Unlike earlier outings, however, they'll have their flight
and board paid for by "Interplast-Germany," a nonprofit
association which supports physicians who, through operations or other
means, free patients of deformations of the face, hands, and feet, or of
burn scars, skin tumors, or war-related ailments.

"Interplast-Germany" is one of numerous private German
organizations helping Pakistan to expand and improve its health-care
system. Another one is the "Hilfswerk Deutscher Zahnarzte fur Lepra
und Not-gebiete" (Relief Agency of German Dentists for Leprosy and
Emergency Regions-DAHW), which plays an integral role in the development
of new pharmaceutical substances, and whose support for the Manghopir
Leprosy Station began many years ago. Today, the Mari-Adelaide Leprosy
Centre in Karachi is the focus of DAHW activities. It is here, for
instance, that Pakistani specialists are trained with German assistance,
from here, all of Pakistan's leprosy control measures are
coordinated. The woman physician who has run, the station for many
years, Dr. Pfau of Germany, also serves as the liaison to the Government
of Pakistan.

Measures of the German Federal Government in Bonn to maintain and
improve health-care services in Pakistan are important elements in the
economic cooperation efforts agreed to with Pakistan. Pakistan ranks
fifth among nations receiving German development support while the
Federal Republic of Germany is Pakistan's third most important
provider of bilateral support. Overall, a total of almost 4,000 million
German Marks had been provided in financial and technical assistance to
the nation up to the end of 1989. Special projects are also included in
this figure. Considerable sums are also being provided for special
programmes for refugees to help Pakistan manage the problems resulting
from the influx of almost three million Afghan refugees.

Projects to consolidate the infrastructure for health-care services
feature prominently in the bilateral assistance efforts in this sector.
These include the establishment of basic health-care units, programmes
for hygiene instruction, and measures in the sanitation area. Also
important is providing instruction for qualified medical staff. For
instance, the Federal Republic of Germany has provided more than 18
million German Marks so far for the expansion of a children's
hospital in Quetta (Province of Balochistan) and about 5.4 million Marks
to provide medical equipment for 17 rural hospitals and two urban
training hospitals, all of them located in the North West Frontier
Province (NWFP). More than 20 million Marks have gone into sanitation
and hygiene projects, about 6 million Marks into the establishment of a
training facility for arthopedic technicians on the grounds of the
Khyber Teaching Hospital, and four million Marks have been earmarked by
the German Federal Govt. for the work of the Public Health Engg.
Department of NWFP.

PHOTO : A team of Duisburg physicians and a surgical nurse (from
left to right) Jurgen Toenissen and Peter Preissler (plastic surgeons)
Dagmar Klode (anesthetic nurse) and Harald Hofer (anesthesiologist).

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